Kornimate/medical-research-clean huggingface dataset:
evaluation of quality of care - shared-care programme, ha

Conditions: Diabetes Mellitus

Summary: diabetes mellitus (dm) and hypertension (ht) are major causes of morbidity and among the top 10 causes of deaths in hong kong in 2008 (department of health 2009). the hospital authority (ha) has initiated service improvement through introducing the shared-care (sc) programme to improve the quality of care (qoc) for dm and ht patients. the evaluation on the qoc is an essential part of the programme in order to inform future policy. the family medicine unit (fmu) of the university of hong kong (hku) has been appointed by the ha to carry out the evaluation of the qoc of the programme. the action learning and audit spiral methodologies to measure whether the target standard of care intended by the sc programme is achieved. each sc participating clinic and private medical practitioner (pmp) will be invited to complete a structured evaluation questionnaire. the data of all patients who have enrolled into the programme will be included in the evaluation on the process and outcomes of care. a hundred and thirty participants will be followed up by telephone to evaluate the effect of the programme in quality of life (qol), patient enablement, and global rating of change in health condition at baseline and 6 months after enrolment. data on the process of care will be retrieved from the ha medical records. main outcome measures: the primary outcomes are the proportion of participants who received the criterion process of care and achieved a hba1c level \<7.5%. data analysis: descriptive statistics on proportions of clinics or subjects meeting the quality of care criteria will be calculated. the outcomes of sc patients will be compared at 6, 12, 24, 36 and 48 months by paired sample t-test. the outcomes between sc patients and control group will be compared by independent sample t-test or chi-square test. hypothesis: the qoc of the sc programme will be determined. areas of deficiency and possible areas for quality enhancement will be identified. the results of this study will provide empirical evidence on whether the ha's sc programme can achieve equivalent qoc as the usual ha care for diabetes mellitus (dm) patients. the information will be used to guide service planning and policy decision making.


Eligibility criteria:
inclusion criteria: * patients with diabetes mellitus who have received care at the specialist outpatient clinic (sopc)for at least 2 years, stratified to be of low risk and have normal renal function as defined by the plasma creatinine level. exclusion criteria: * patients will be excluded if they are stratified to be at high cardiovascular risk or are suffering end stage renal failure, on dialysis or after transplantation, or on insulin, or do not give consent to be transferred.

Keywords: diabetes mellitus
a study of the safety and effectiveness of adx-n05 in the treatment of excessive daytime sleepiness

Conditions: Narcolepsy

Summary: this is a study to evaluate the safety and effectiveness of adx-n05 compared to placebo in the treatment of excessive daytime sleepiness in adults with narcolepsy.


Eligibility criteria:
inclusion criteria: * diagnosis of narcolepsy * good general health * willing and able to comply with the study design and schedule and other requirements exclusion criteria: * if female, pregnant or lactating * customary bedtime later than midnight * history of significant medical condition, behavioral or psychiatric disorder (including suicidal ideation), or surgical history * any other clinically relevant medical, behavioral or psychiatric disorder other than narcolepsy that is associated with excessive sleepiness * history of significant cardiovascular disease * body mass index \>34 * excessive caffeine use - \> 600 mg/day of caffeine or \> 6 cups of coffee/day * history of alcohol or drug abuse within the past two years * nicotine dependence that has an affect on sleep
stretching the posterior capsule of the shoulder in the stability and the throwing performance in handball players

Conditions: Shoulder Injuries and Disorders

Summary: introduction: handball is a sport with a high prevalence of shoulder injuries due to the overuse that causes a glenohumeral internal rotation deficit, and excess of external rotation and scapular dyskinesia. stretching is essential to restore physiological movement and improve strength. aim: to evaluate the efficacy of a posterior capsule stretching and strengthening of the shoulder and scapular program in handball players from 18 to 37 years old. study design: randomized clinical trial, multicenter, single-blind with follow-up period. methods: 60 handball players will be randomly assigned to the two study groups (experimental and control). the intervention will last 4 weeks, with 3 weekly sessions with a duration of 21 and 12 minutes each. the study variables will be: range of motion in internal and external rotation (goniometer), throwing speed (ball throwing speed test), functionality (dash questionnaire), perceived exertion (borg scale), glenohumeral stability (ckcuest y ybt-uq test) and the throwing force (overhead medicine ball throw). the intervention will consist in the application of stretching of the posterior shoulder capsule with an exercise protocol. a kolmogorov-smirnov analysis will calculate the normality of the distribution. in case of homogeneity of the groups, with the t-student test of repeated measurements and an anova of repeated averages, the difference between the different evaluations and the intra- and inter-subject effect will be calculated. expected results: improved range of motion of the shoulder, strength and throwing speed after the intervention.


Eligibility criteria:
inclusion criteria: * female * handball players federated in the madrid handball federation * with an age range between 18 and 37 years * more than 2 years of handball sports * currently participate in amateur competitions of first national women's category. exclusion criteria: * have suffered a shoulder injury in the last six months * who are currently doing some physiotherapy treatment * who fail to participate in the established intervention and evaluation sessions * refusing to sign the informed consent document.

Keywords: handball physiotherapy shoulder instability scapular dyskinesia female
furosemide treatment before blood transfusion in patients with systolic dysfunction

Conditions: Anemia Treatment Among Patients Suffering From Left Ventricular Systolic Dysfunction

Summary: the study objective is to assess the clinical and echocardiographic changes of patients with systolic dysfunction receiving blood transfusion, with or without prior treatment with furosemide

more than 4 million patients receive a blood transfusion each year in the united states, many of them suffer from congestive heart failure. the reported prevalence of anemia in chf is unknown, ranges widely from 4% to 70%, due to a lack of an established, consistent definition of anemia in chf. treating chf patients with furosemide prior to blood transfusion became a common practice, even though no randomize clinical trial had examine this issue. nand et al. measured the pulmonary capillary wedge pressures in 20 adults with chronic severe anemia (hg \<6 mg/dl) and no systemic disease before and after transfusion of 700ml of whole blood. ten of these patients were treated with furosemide (40 mg intra-venous) immediately prior the transfusion. the pcwp had increased significantly among patient who did not receive the furosemide and decreased by 3.75% among patients in the furosemide group, although this change was not was statistically significant. in another study, the same group of nand et al. measured the pcwp among 40 chronic anemia patients receiving blood transfusion. none of the patients suffered from cardiopulmonary disease. the patients were randomly divided into 4 groups: the difference between the first 3 groups was the speed of the transfusion (2 ml/min, 5 ml/min and 10 ml/min). the fourth group patients were treated with 40 mg of furosemide before the transfusion was given in a rate of 5 ml/min. the pcwp increased significantly in the first 3 groups, with the rise being proportionately greater with faster transfusions (15.8, 20.9 and 32.2% in groups a, b and c, respectively). in the furosemide group, however, the pcwp decreased significantly by 21.7%.

Eligibility criteria:
inclusion criteria: * subject is over 18 years old. * documented ejection function equal to or over 40% in prior tests * the treating physician decided to treat the patient with packed cell exclusion criteria: * known hypersensitivity to furosemide. * calculated creatinine clearance over 20% (by mdrd) * past adverse reaction to blood product.

Keywords: furosemide anemia lv dysfunction blood transfusion
tvns in children with prader-willi syndrome

Conditions: Prader-Willi Syndrome; Social Behavior

Summary: the purpose of the current project is to test the impact of transcutaneous vagus nerve stimulation (tvns) on social ability in children with prader-willi syndrome (pws). social ability and blood neuropeptides associated with social functioning will be measured before and after engagement in 12 weeks of tvns therapy.


Eligibility criteria:
inclusion criteria: * (1) be between the ages of 8-14 years; (2) have a confirmed diagnosis of pws by genetic testing; (3) be minimally verbal and able to sit at a table to complete cognitive and behavioral testing; (4) be willing to provide blood samples; and (5) be willing to engage in a 16-week study period (baseline to intervention follow-up). exclusion criteria: * (1) currently taking oxytocin and/or arginine vasopressin or related analogs and (2) have a dsm-5 diagnosis of any severe mental or behavioral disorder (e.g. schizophrenia, bipolar disorder, conduct or oppositional defiant disorder) that significantly impacts daily functioning.
comparison of the therapeutic effects of intra-articular injection of ozone and corticosteroid in knee osteoarthritis

Conditions: Knee Osteoarthritis

Summary: this clinical trial aimed to involve patients aged 40-85 years who had been experiencing knee pain for at least 6 months and had received a clinical diagnosis of knee osteoarthritis through radiologic imaging. the patients were randomly assigned to two groups. one group received a 3-week intra-articular injection of 15 mg/ml ozone, while the second group received a 1 ml intra-articular injection of betamethasone. all patients were evaluated before treatment, as well as 4 and 12 weeks after the first dose of treatment. the study evaluated treatment efficacy using the visual pain score (vas) and the western ontario and mcmaster universities arthritis index (womac).


Eligibility criteria:
inclusion criteria: * 40-85 years old, * have experienced knee pain and/or limited joint range of motion for at least 6 months, * have a diagnosis of koa supported by radiographic imaging. exclusion criteria: * patients had undergone knee joint surgery, * had a history of previous intra-articular injections, * had any rheumatological disease or malignancy, * being pregnant, * had pain radiating to the knee and leg.
impact of remote care in patients diagnosed with thromboembolic disease of low risk

Conditions: Thromboembolic Disease

Summary: the goal of this clinical trial is to learn about the feasibility and impact of remote care in patients diagnosed with thromboembolic disease of low risk. the main questions it aims to answer are: * the evaluation of feasibility of organisation between different healthcare professionals (hospital physicians, primary care physician) at 6 months and 1 year * the evaluation of complication rate, hospitalisation related to thromboembolic disease rate, compliance to treatment rate at 6 months and 1 year participants will receive indication of treatment according to national recommendations. additionnally, they will receive for the length of study a 4g tablet in order to fill questionnaires, learn information about their drugs (patient education), have a remote consultation and evaluate treatment compliance.


Eligibility criteria:
inclusion criteria: * patients identified in the emergency department with a thromboembolic disease, with a deep vein thrombosis or pulmonary embolism with a low risk of mortality according to recommendations * affiliated or beneficiary of social protection exclusion criteria: * patient having a severe obstruction syndrome, a thromboembolic disease already under treatment or a suspicion of thrombocytopenia induced by heparin * patient with an active hemorrhage or a major risk of hemorrhage, a renal severe failure, comorbidities such as cancer, or the impossibility to organise a consultation or a patient in a non favorable medico-social context * patient with a caval thrombosis * patient suffering of a disease at hemorrhagic risk or neurosurgery intervention done in the last month or other surgery in the last 15 days prior to inclusion * patient with contraindication of direct oral anticoagulants, such as bitherapy with antiplatelet agent, imidazoles, macrolides, antiretroviral treatments or an anti-phospholipid syndrome * patient that lives in an area not covered by internet * patient that has no primary care physician * patient not able to understand the study (language, psychological problem) or not able to read or write * patient under legal protection
parental mental health after tracheostomy in early childhood

Conditions: Tracheotomised Children; Anxiety of Parents; Depression of Parents

Summary: to assess the prevalence of anxiety / depression in post- hospital for parents (mothers and fathers) of children with tracheotomy before the age of 1 year between 2000 and 2012.

the goal of this study is to evaluate the level of anxiety / depression of families and to correlate to the lived parental of tracheotomy and indirectly that of the child (hetero - evaluation). the information from this study should allow staff to refine and adjust their practices in terms of information and support for families with tracheotomised children. the information given to families before the establishment of a tracheotomy for their child may also be adapted.

Eligibility criteria:
inclusion criteria : families whose child : * has been tracheotomised before the age of 1 year between 2000 and 2012 * came out of hospital with a tracheotomy tube * is or has been followed by one of three centers exclusion criteria : * children decannulated before hospital discharge . * death before the start of the study

Keywords: tracheotomy anxiety depression back home
cardiac implantable electronic device- induced remodelling of tricuspid valve and right chambers

Conditions: Cardiac Pacing, Artificial; Tricuspid Valve Regurgitation, Non-rheumatic

Summary: this single-center longitudinal study aims to evaluate the occurrence and clinical impact of tricuspid regurgitation (tr) after cardiac-implanted-electronic-device (cied) implantation by comprehensive echocardiographic assessment, including advanced three-dimensional (3d) transthoracic and transesophageal imaging. the primary objective of this study is to assess the prevalence and leading mechanism of new or worsening tr, defined as an increase of at least one grade on a five-grade scale, after new cied implantation. secondary objectives include clinical and echocardiographic endpoints at discharge, three months, one year, and annually for up to five years. they can be summarized as follows: 1. to evaluate morphological and functional changes (remodeling) of the tricuspid valve (tv) apparatus and right-sided heart chambers in patients undergoing new cied implantation. 2. to identify risk factors for new or worsening tr after cied implantation on an anatomical, procedural, and clinical level. 3. to determine the clinical impact of new or worsening tr after cied implantation. 4. to explore the treatment strategies for lead-related tr (observational).


Eligibility criteria:
inclusion criteria: * age ≥ 18 years * patient able and willing to give informed consent in written form before the index procedure * patient understands the purpose, the potential risks as well as benefits of the study and is willing to participate in all parts of the follow-up * patients undergoing any new cied implantation with or without transvalvular lead * sufficient imaging quality on transthoracic echocardiography to assess tr severity grade and morphology of right-sided heart chambers exclusion criteria: * previous or present cied * life expectancy \< 12 months due to non-cardiac condition * tricuspid valve stenosis of any severity or severe tr planned for intervention (transcatheter, surgical) within the next 12 months * previous tricuspid valve intervention (transcatheter, surgical) * participation in another study, which would lead to deviations from this trial protocol

Keywords: cardiac implantable electrical devices tricuspid regurgitation three-dimensional echocardiography right ventricular remodeling
european study on encephalitis in intensive care

Conditions: Encephalitis

Summary: prospective observational multicenter study in european icus. all patients admitted to the icu for probable or confirmed acute encephalitis (2013 idsa - infectious disease society of america criteria) will be included. factors associated with a poor prognosis will be identified by multivariate analysis using a logistic regression.

primary objective : evaluate the correlation between mrs score and the baseline characteristics functional outcomes will be evaluated using the modified rankin score (mrs) score, which is one of the most frequently used scores in acute neurological diseases \[18\]. a poor outcome will be defined by a mrs score \> 2 (functional dependence or death). the investigator usually evaluates this score if the patient is still in the hospital 90 days after admission. patients discharged from hospital within 90 days following icu admission without major disability (mrs 0, 1 or 2) are considered to have a good outcome. patients discharged within 90 days with a disability will be classified for the study according to the latest available data. patients will not be contacted directly by the investigator for the study purposes. secondary objectives : to identify additional prognosis factors : the clinical, radiological, biological and neurophysiological factors associated with poor outcome for patients admitted to the icu with ae * day 28 mortality, in-icu mortality, in-hospital mortality * major systemic complications (septic shock, hyponatremia, nosocomial pneumonia, catheter-related bsi, overt gastroenteral bleeding, pulmonary embolism) * major intracranial complications during icu stay * status epilepticus * brain death * empyema/cerebral abscess * cerebral ischemia * intracranial bleeding * icp monitoring * neurosurgery the cause of death will be categorized into 2 categories: * systemic causes (cardiovascular failure, mof) * neurological cause (diffuse neurologic injury or withdrawal of care)

Eligibility criteria:
inclusion criteria: * age ≥ 18 years * non-opposition to participate in the study (or consent if applicable according to local legislation) * impaired consciousness (altered mentation, stupor, or personality changes) for a duration ≥ 24 h, without obvious explanation * a score on the glasgow coma scale \< or =13 at icu admission * a cerebrospinal fluid pleocytosis \> = 5 cell / mm3 * at least 2 of the following : * fever (≥ 38.0 °c) within 72 hours before or after admission * generalized or partial seizures non-attributable to pre-existing epilepsy * new onset focal neurological deficit * parenchymal abnormalities on mri compatible with ae * eeg alterations compatible with ae. exclusion criteria: * csf or neuroimaging not available (s) or not performed. * febrile encephalopathy associated with another diagnosis (sepsis, neurological disease with aspiration pneumonia ... )

Keywords: icu, encephalitis, meningo-encephalitis, seizures
effects of combined exercises on primary dysmenorrhea

Conditions: Primary Dysmenorrhea

Summary: dysmenorrhea is one of the most common gynecological problem in adolescents and young women. symptoms of dysmenorrhea include pelvic / abdominal pain, back pain, headache, nausea, vomiting, diarrhea. these symptoms occur before menstrual bleeding or with bleeding and lasts in 12-74 hours. the objective of this study to investigate the effects of combined exercises on dysmenorrhea symptoms. exercise protocol aerobic, stretching, kegels, pelvic motions and relaxation exercises.

women with a positive primary dysmenorrhoea symptom between 18 and 30 years of age living in the turkish republic of northern cyprus will be included in the study. according to the result of the power analysis, 14 subjet for control and 14subjet intervention group were decided. the eligibility criteria for this study are: * the visual analogue scale value is at least 5 per day when the dysmenorrhea symptoms are the most painful, * to have the regular menstrual cycle (24-35 days), * to be sedentary the exclusion criteria for this study are: * women with secondary dysmenorrhea, * the women who gave birth or abortion, * people with active sexual experience, * women who use intrauterine devices, * individuals with regular drug use, * serious psychological problems * acute musculoskeletal problems, * people with neurological or cardiopulmonary disease this research will consist of exercise and control groups. an exercise protocol consisting of a combination of various exercises will be applied to the exercise group and no exercises will be done for the control group. women in the exercise group will perform two menstrual cycles, three times a week in the presence of a physiotherapist. assessments will be made on the day that the symptoms are seen to be the most severe in order to determine the symptoms of the women in both groups. after baseline assements exercises will start at 3rd day of cycle. assesments will repeat at second and third menstrual bleedings. visual analogue scale, menstrual symptom questionnarie and pittsburgh sleep quality index will be use.

Eligibility criteria:
inclusion criteria: * the visual analogue scale value is at least 5 per day when the dysmenorrhea symptoms are the most painful, * to have the regular menstrual cycle (24-35 days), * being a sedentary (not participating in any regular exercise program). exclusion criteria: * women with secondary dysmenorrhea, * the women who gave birth or abortion, * people with active sexual experience, * women who use intrauterine devices, * individuals with regular drug use, * serious psychological problems * acute musculoskeletal problems, * people with neurological or cardiopulmonary disease.

Keywords: exercise